It's not your typical chair massage. The name given to one of the techniques of tui na work -- double dragon walking -- is symbolic of the roots of this ancient Chinese folk medicine that aims to balance the energy system of qi (chi) and treat the musculoskeletal system all at the same time. And in China, says Xiping Zhou, a doctor of oriental medicine and licensed acupuncturist, it's usually performed with the client on a simple office chair. Zhou, the founder and president of East-West Healing Arts Institute in Madison, Wis., says the chair is a perfect place for tui na practice -- clothes on, no oils, and yet a deep healing and energizing massage.

Tui means push, and na, grasp, thus the techniques are a combination of these motions, using not only the hands and fingers, but also elbows, forearms, fists, and knuckles. Tui na developed out of Asian massage as described in the earliest surviving text of Chinese medicine, The Yellow Emperor's Classic of Internal Medicine, dated approximately 200 BCE. However, the term tui na did not surface until the Ming dynasty (1368-1644). Prior to that, therapeutic massage was more popularly called ammo, translated to press and rub.1
According to Zhou, as a Chinese medical massage, tui na is also a part of Chinese physical therapy. Beyond the benefits of relaxation, tui na is a rehabilitative approach addressing specific conditions, such as headache, carpel tunnel, fatigue, and stress. "It's more direct than Western massage," Zhou says. By working simultaneously on the energy and musculoskeletal systems, the massage delivers a double punch. Meridians are located along many muscle areas and the techniques can affect both. The soft and deep tissues are worked and the yin and yang are balanced, promoting circulation of qi while also increasing blood flow.

Zhou trained and practiced in China before bringing his work to the United States. Although it takes many years of training to become an expert in tui na, he says Western massage therapists can benefit from learning and applying some basic techniques in their practice. His chair routine can be completed in about 35 to 45 minutes, with work focused on the head, shoulders, neck, back, arms, wrists, and hands. Even an abbreviated 10-minute version of the routine, he says, will produce quick results for clients.

Yet, traditional chair massage this isn't. The work sometimes elicits an "Ow, ow!" from the client. "Compared to Western or Swedish massage," Zhou says, "Chinese massage, or tui na, is more vigorous and deep. It can be somewhat painful, but we call it a 'good hurt.'" Despite the mild discomfort, many of his pain management clients are more inclined to opt for tui na rather than acupuncture, he says, preferring hands-on work to needles.
Zhou says there are several reasons why tui na chair massage is more effective and produces better results than the standard Western approach. The first has to do with proper body mechanics. "The posture of the therapist is different in tui na," he says. "The standing position is a horse-stance posture similar to tai chi. This allows the therapist to use less effort while creating more pressure. They can do deeper work on muscles without using so much effort."

As compared to Swedish massage, tui na also uses more strokes and techniques; for example rolling, kneading, and grasping are combined with stretching and acupressure techniques. In addition, there is a difference in application to the area being covered by the technique because not only are muscle groups involved, but also acupressure points or meridians. "This works not only to reduce tension but also to increase flow of vital energy and alleviate problems like carpel tunnel," Zhou says.

The energy work helps the client become more focused. "Seated tui na is more therapeutic or medical than Western massage, which is more for relaxation," he says. "With tui na, the client feels energized and rejuvenated because of the opening of the qi system."

Therapists benefit from this approach as well. There is less wear and tear on the practitioner's fingers, with much of the work being done with fists, knuckles, and other body parts. Techniques such as rolling also serve as hand-saving alternatives. Zhou says this allows the therapist to work on more clients without getting tired or injured.

Prior to beginning tui na massage, the client is asked if they've had this type of work before and if they have a specific area of concern. But in addition, Zhou says, there is another important question regarding the energetic aspect: "Have you eaten a meal? Because tui na is very powerful, it is not recommended to have a treatment on an empty or too full stomach."

Zhou calls his tui na chair approach a "revolution of massage technique." The difference is not only in the movement and mechanics, but the quick response of relief for the client. Truly a good hurt.

Examples of Tui Na Chair Massage TechniquesRolling: On the back; use fists on the back, with the two palms facing each other.Grasping: On the neck or shoulders; use two hands with fingers crossing each other, grasping on the back of the neck or side of the shoulder joint; loosens tension. Acupressure Technique: On the meridian point, midpoint of the shoulder (GB 21); use thumbs to hold this point; loosens tension. Fist Kneading Technique: On the lumbar region, for lower back pain; press using the back of the palm fist; pressing
2 to 3 times also use breathing techniques, having the client inhale and exhale rhythmically; good for stiff back.Butterfly Technique: On the back; cross the hands and use the heel of the palms, kneading down from upper to lower back; loosens back musclesDouble Dragon Walking Technique: On the back; use thumbs to walk along the spine to stimulate and balance the governing meridians, with the two thumbs crossing either side of the spine and walking down three times from upper to lower; balances qi and blood flow and loosens back muscles.

Reference
1 Miller, Matthew. A Brief History of Chinese Therapeutic Massage. Available at www.acupuncture.com/qigong_tuina/tuinahistory.htm. Accessed November 2005.